Surgical skills training is becoming increasingly important as medical technology advances. New surgical procedures typically require additional training before the trainee is ready to attempt surgery on real patients. This is especially true for many of the newer, minimally invasive surgical techniques, such as beating heart surgery. For example, coronary arterial bypass grafting (CABG) is a routine operation that requires much training and practice to reach and maintain an appropriate level of skill. Surgeons and surgical trainees alike benefit from practice of this and other types of surgery that use minimally invasive techniques.
In traditional cardiac surgery, the heart is arrested for surgery, and the field is dry and motionless. However, in beating heart surgery, the surgeon must perform surgical procedures while the heart continues to beat. There is consequently no safe and relatively easy situation in which to offer trainees the chance to perfect surgical skills on the beating heart, as it is not typically considered safe to allow new trainees to operate on real patients.
Additionally, in developing countries, lack of resources and high demand on a small number of trained surgeons make surgical skills training an especially important area, as trainee surgeons are typically under-exposed to surgical techniques. Even in developed counties, legislation placing a maximum on the number of hours worked per week also limits on-the-job training opportunities, as hospital doctors have less time for training during working hours.
Simulators are a known technique for providing addition surgical training. For surgical techniques that require an increased level of skill, such as minimally invasive surgery, simulators provide an especially valuable tool. Many known surgical training simulators use latex models of organs and/or computer-generated virtual reality systems. However, these provide only limited realism, and are expensive. Anaesthetized animals have been used for in vivo training, however the ethical concerns of using live animals for such training present a large drawback. There is therefore a need for an ex vivo simulator that can will provide surgeons a realistic training environment.
In the field of beating heart surgery, it is known to use a prosthetic model of a beating heart to simulate clinical situations of beating heart surgery. A prosthetic heart model attempts to duplicate the exposure and feel of a beating heart during surgery, and allows both the surgeon-in-training as well as the veteran surgeon the opportunity to develop skills needed for consistent results when performing cardiac surgery on the non-arrested heart.
While known prosthetic beating heart models provide the trainee surgeon with the ability to handle the prosthetic heart during simulation, and the ability to use stabilizers during training surgery, known prosthetic heart models do not allow for continuous perfusion of fluid through the prosthetic heart, nor do they provide for a realistic feel of the heart tissue. Known prosthetic hearts are typically composed of latex or silicone, which do not provide for a truly realistic feel and touch of human tissue. In addition, the lack of continuous perfusion may give a trainee a false impression of hemostasis and manipulation of the heart. Known prosthetic beating heart models therefore do not provide an environment that is realistic enough to simulate true beating heart surgery for training purposes.
In view of the foregoing considerations, it is clear that there is a need for realistic beating heart model that allows for continuous perfusion of fluid and provides a realistic feel of heart tissue. In addition, it would be advantageous to have a beating heart model that could simulate the range of normal and abnormal heart rhythms that may arise during surgery, such as those resulting from intra-operative events such as admission of drugs or from ventricular fibrillation.
It would be useful to have a beating heart simulator that provides a more realistic environment for surgical training, including continuous perfusion and simulation of the range of intra-operative cardiac behaviors typically found in heart surgery. The present invention provides such an apparatus and system.